The effect of the palatoplasty method on the frequency of ear tube placement.
OBJECTIVE
To determine whether the type of palate repair affects the frequency of subsequent ventilation tube placement.


METHODS
Combined retrospective and prospective cohort with more than 2 years clinical follow-up after palatoplasty.


METHODS
Tertiary care children's hospital and clinic.


METHODS
A total of 170 patients with cleft palate (with or without cleft lip) underwent palatoplasty between 1995 and 2003. Sixty-nine patients with less than 2 years of follow-up visits and 1 patient who did not require ear tubes were excluded from this analysis.


METHODS
Either traditional 2-flap palatoplasty (group A) or double-opposing Z-plasty (group B) was performed. The type of palatoplasty performed was based on the reconstructive surgeon's clinical decision. Ventilation tubes were placed for otitis media, conductive hearing loss, or eustachian tube dysfunction. Patients received routine follow-up care every 6 months or whenever acute problems arose. Data were analyzed with independent t tests, chi(2) tests, and Fisher exact tests.


METHODS
Number of ear tubes placed after palatoplasty in each group.


RESULTS
Group A had a mean (SE) of 2.9 (0.2) sets of tubes placed, while group B had a mean (SE) of 1.8 (0.2) sets of tubes. Group A had significantly more sets of ventilation tubes placed (P < .001) than group B. Subgroup analysis based on type of cleft was performed.


CONCLUSIONS
Children with cleft palate who underwent double-opposing Z-plasty had fewer sets of ear tubes placed postoperatively than patients who had traditional repair.
Smith
Lynnelle K
LK
Department of Otolaryngology/Head and Neck Surgery, Oregon Health & Science University, 3181 Sam Jackson Park Rd, Portland, OR 97239-3098, USA.
Gubbels
Samuel P
SP
MacArthur
Carol J
CJ
Milczuk
Henry A
HA
D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000175:diagnosis / Q000601:surgery*; D002972:Cleft Palate / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation / Q000379:methods / Q000706:statistics & numerical data*; D019647:Oral Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D010034:Otitis Media with Effusion / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D011336:Probability; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D016896:Treatment Outcome